Expert Describes Meningitis, Says Epidemic Unlikely

April 17, 1986|by DAN PEARSON, The Morning Call

A specialist in infectious diseases told a jammed lecture hall of 300 Muhlenberg College students last night that a campus epidemic ofbacterial meningitis is unlikely when its presence is known and proper precautions are taken by college physicians and students.

"The majority of cases occur within two days after the original case (positive diagnosis). After a week passes, you usually can get by without an epidemic," said Dr. Jeffrey Jahre of St. Luke's Hospital during an hour- long briefing in the Trumbower science building.

Students streamed into the lecture room at 6:30 p.m. after learning that freshman Harris Sherman, 19, a resident of Prosser Hall, had died early yesterday of meningococcal meningitis, a deadly form of the disease that often attacks the membranes of the brain and spinal cord, and other vital organs.

The hastily-arranged briefing presented by the college administration and Dr. Steve Goldman, director of Muhlenberg's Health Center, replaced an educational program on AIDS that will be rescheduled in this semester.

After last night's briefing and dialogue, some students and faculty members attended a memorial service for Sherman in Egner Memorial Chapel. It was noted on the printed program that chartered buses will leave Muhlenberg at 9 a.m. today for those students who wish to attend the 2 p.m. funeral service for Sherman in Rockville Center, Long Island.

Joining Dr. Jahre last night in presenting facts about the disease and answering the questions of concerned students was Barbara Stader, associate director of the Allentown Bureau of Health. Together they made these points about a disease that comes in different forms and ranges from mild symptoms to death:

- Bacterial meningitis occurs more often in men than among women. Apart from the common headache, stiff neck and high temperature, meningitis frequently causes a tell-tale rash at the waist and other pressure points "that lookslike a little bleeding under the skin." About half of the patients who reach the foaminating stage (bubbles clustering over the nose and mouth) do not survive.

- The unfortunate combination is that of a virulent strain of the disease and a host (human body) that is not resistant. High resistance, it is believed, can be enhanced by observing the basic health rules: 7-8 hours of sound sleep, adequate and nutritious food, avoidance of fatigue, excessive drinking and smoking.

- Viral meningitis is very common and not a great danger to health. It's the airborne bacterial variety, particularly strains A and C, that trigger the epidemics in military barracks where personnel live in such close proximity and breathe each other's air.

- An estimated 5-10 percent of the American population carries the bacterial form which lives only in humans. Animals are "not a reservoir" for the germs. Although people are not born with the bacteria in the nasal passages, they can become a carrier for life or for "transient periods." About 70 percent of the soldiers crowded into a barrack can become carriers without an epidemic resulting.

- Donating blood to a community bank would not increase one's risk of contracting meningitis provided that a person is in generally good health. But they should never donate if they do not feel well. Drinking sacramental wine from a chalice would not expose a parishioner to the disease because it is not known to be transmitted in that way. Kissing, hugging and inhaling another's breath at close range are definite risks if one person is a carrier.

- The antibiotic Rifampin is given as a preventive pill "to get rid of the carrier state." After taking the drug for two days (two pills twice a day), the drug is 95 percent effective in removing the organism from thenasal passage and throat of the patient. Panic should be avoided since some people tend to run high fevers (103 to 105 degrees) when their body is battling any type of infectious illness. Temperatures rarely go above 106.

- If a doctor suspects that a person has contracted a dangerous form of meningitis, he will order hospitalization and treat the patient intravenously with penicillin. The earlier the treatment starts, the better the chance that the victim will survive. There is a vaccine for the disease, but since most of the serums take seven to 10 days to take effect, "it is not useful in acute situations."

- The most common test for diagnosis of the disease is a spinal tap, which normally indicates its presence and shows other things. Doctors usually do not order cultures of body fluids because they take time and there are so many carriers in the population, anyway. Vulnerability to menigitis usually drops off dramatically after the person reaches the mid-20s and has developed some immunity. It is not a common cause of death among the elderly.

During World War II, spinal meningitis was a problem on submarines, where men were literally jammed into crews quarters scaled down to make room for engines, batteries and torpedoes.

Meningitis also was a problem at many Army training camps during the war. The most notorious in this regard was Fort Ord, California, a huge camp that also served as a debarkation point for troops being sent to islands in the Pacific theater. Fort Ord had occasional epidemics that required the evacuation of barracks, building disinfection and sometimes the closing of sections for months at a time.